Individual
JACQUIE WEDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 W KNOX AVE, SPOKANE, WA 99205-4323
(150) 935-4652
(509) 354-6400
Mailing address
1300 W KNOX AVE, SPOKANE, WA 99205-4323
(150) 354-6523
(509) 354-6400
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60651058
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MEDICAID
—
WA
Enumeration date
09/28/2016
Last updated
09/28/2016
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